Norristown State Hospital, formally the 'State Lunatic Hospital at Norristown', is an active psychiatric hospital run by the Commonwealth of Pennsylvania, and has been operational since it's opening in the spring of 1880. At it's height in the 1940's it maintained a clinical population of about five thousand patients, and held national renown for its modern psychiatric practices. In more recent years, Norristown State's population has declined significantly to that of about 150 civilian beds. The Commonwealth of Pennsylvania continues to maintain the site, but at a greatly reduced size and clinical capacity. It is currently the only remaining state psychiatric facility active in south-eastern Pennsylvania with the closure of Philadelphia State Hospital in 1990, Haverford State Hospital in 1998, and Allentown State Hospital in 2010. It continues to serve the five surrounding Pennsylvania counties- Philadelphia, Bucks, Montgomery, Delaware and Chester.

Since much of the original grounds belonging to the 1880 asylum are no longer used by the modern hospital, it has since been sub-divided to the care of local agencies, such as: Norristown Farm Park, Norris City Cemetery, Elmwood Park Zoo and West Norriton Fire Department. The buildings that remain active with Norristown State Hospital tend to be more modern structure capable of catering to modern psychiatric practices. There are, however, a large number of building on site that are inactive, or completely abandoned and waiting for demolition. The Commonwealth of Pennsylvania has not made any formal statement about what they intend to do with the site in the long term, or if they intend to completely close the state hospital in the immediate future.

In May 1876, Governor John Hartranft formed a blue-ribbon commission to study the civic need for additional state asylums to tend to the overcrowded county almshouses in the region. They examined the possibility of opening this facility outside of Philadelphia, but without a specific location indicated. They found that Norristown would prove an appropriate location for this project. In that same year, under Public Law 121, the Pennsylvania Legislature called for the establishment of a state mental hospital to serve the Southeastern District of Pennsylvania for the benefit of the poor and those individuals deprived of their reason. A two hundred and sixty five acre tract in the northern part of Norristown borough (which now split between the city of Norristown and East Norriton Township) was chosen for the asylum grounds, at the crossing of Stanbridge and Sterigere Streets. At the time of its construction many of the local residents were farmers, or in the business of agricultural supplies. The properties of Norristown State Hospital were obtained from eight individual properties of local landowners, obtained between the hospital's construction in 1878 and 1918. They were:

Stony Creek Mills - owned by 'Markley, Smith & Co.' However, the property was damaged and in a state of disrepair when it was purchased. It has been suggested, when the Hospital was built in 1879, stones from the mill walls were used in the original buildings.

Matthias Scheetz- who possessed a house on the property, as well as a grist mill that was active until construction began. It has been suggested that this is the old superintendent's house.

James McIntyre- who owned the two-story white stone house that now stands abandoned at 1515 Sterigere Street, near Gate #4. It was used by resident farmers and security alike in the past.

Peter McGuire- his property was reportedly a tan-yard, he sold the property in 1878 at a price of $18,500.

Joseph Greaves- who possessed a one story log cabin on the site, which he sold to the state in 1878. There are no remains.

Jacob Moyer- who owned a two story stone farmhouse on the site. This lot was purchased by the Commonwealth in 1895, as an expansion to the hospital property.

Frederick A. Poth- his property reportedly was a large two story house and store, which was sold in 1907 to the Commonwealth of Pennsylvania. It still currently stands on Whitehall Road, albeit abandoned and boarded up. While the state hospital was active, a resident farmer lived here, who assisted with the care of the grounds.

Daniel Yost - who owned this two story house and grist mill. This house, at 660 West Germantown Pike was purchased by the Commonwealth in 1918. While the state hospital was active a resident farmer also lived here, until the mid-1970's. The house was torn down in 2012 to expand Germantown Pike.

Work began on the administration building on March, 21, 1878. $600,000 was secured by the legislature of the commonwealth for this project and the construction of the seven original wards. This year can be found engraved at the top of the tower on the Administration Building at Norristown (Building #19), at the front of the hospital complex. The design for the original 1880 complex came from Philadelphia based Wilson Brothers & Company, also known for their design of Drexel University and Reading Terminal. Upon the primary structure's completion on February 17, 1879 there were only two other state-owned hospitals operating, one in Danville, which opened in 1872, and one in Harrisburg, that opened in 1851. At the time, other plans were underway to construct another at Warren. Norristown was built to alleviate the overcrowding in the psychiatric wards of the Philadelphia Almshouse, as well as private hospitals, such as Friends Hospital and the Pennsylvania Hospital. At its opening, the hospital was turned over to the Board of Trustees with its thirteen members for operation, which still controls and oversees the welfare of the physical hospital and it's operation. From its opening, the hospital was opened to both sexes, albeit segregated, and continued to be divided into independent male and female departments until 1923. In 1924, when the asylum was serving nearly three thousand patients, the hospital was reorganized under a single superintendent.

As with most state hospitals at the time, there was a farm with livestock and crops on the grounds and the patients helped to operate the facility well into the 1970's. A number of barns and cottage homes were also built across the property, sometimes permitting semi-autonomous patients to live together. Norristown State Hospital continues to operate a farmer's market on the grounds currently at its greenhouses, which are open to the public. However, nothing is grown on site, and most of the former farmland are currently under the jurisdiction of Norristown Farm Park. Roads and sewers were built on the property, most of which remain active, and a large portion of the grounds were enclosed by an cast-iron fence, eight feet high. This cast-iron fence is still operational and can be seen from Sterigere and Stanbridge street. Barns and a root-house were also constructed at the hospitals opening, many of which also still survive on the grounds. The sewage was emptied into Stony Creek until 1900, or so, when it was found to be injurious to the local wildlife.

The general dimensions of the separate ward buildings were originally 277 feet in length by 90 feet in depth. Each ward building consisted of a basement, used for steam-heating ducts and workshops, and two main stories, each containing two wards and giving four wards to each ward building. Each ward was originally complete in itself, with separate patient rooms, dormitories, dining-rooms, and bath-rooms. The wards are ventilated by stacks with steam coiled at the base for creating the drought that draws the air from the wards.

Norristown State Hospital received its first patient, a woman, on July 12, 1880 under the supervision of Dr. Robert H. Chase and Dr. Alice Bennett. Two more women arrived on July 13th followed by the first two men on July 17th. Very soon thereafter groups of individuals were admitted from other state hospitals and county almshouses. By September 30, 1880, there were 295 men and 251 women receiving inpatient care and treatment.

Norristown State Hospital was the first of the Pennsylvania state hospitals to construct its buildings deviating slightly from the "Kirkbride Plan", best known as "Transitional Plan". Instead of constructing a single monolithic building, the individual patient wards were separated and free-standing. These building were connected with a series of underground tunnels, including a central tunnel which stretches across the property. Norristown still maintains the schematics of Kirkbride's original plan, with it separation of male and female departments, as well as leveling the acuity of patients by ward.

There was a tremendous emphasis during the early period on a 'humane' approach to psychiatric treatment ("moral therapy") allowing the individual as much liberality as his/her condition would permit, which was common of the period. Several low-acuity wards were unlocked for periods of time, and grounds privileges was a common feature of daily life. Work assignments became a significant feature of a patient's daily routine, many focusing on the workings of the state farm. They were not limited to farm work, other occupational departments include: Administration, Bakery, Billiard room, Boiler room, Bric-a-brac shop, Brush shop, Butcher, Carpenter shop, Dispensary, Garden, Kitchen, Laundry, Machinists, Mattress shop, News-room, Out-door improvement, Painters, Plasterers, Plumbers, Printing office, Scroll saw shop, Shoemakers, Stables, Store-rooms, Tailors, Wards and dining rooms and Weavers. However, with the change in Pennsylvania State Law in the 1970's, hospital patients were no longer permitted to be involved in farm labor. Thereafter, the farmlands were employed by separates agencies of the city of Norristown, namely Norris-City and Norristown Farm Park.

The hospital was organized into three sections - men, women, and a business section headed by a steward. Each section was completely independent of the other, with almost completely separate services. The staff of the men's unit was for sometime all men, and the staff of the women's unit all women. A Nursing School was established in 1897, at this time the hospital census had passed two-thousand patients. Accommodation was also made for nurses on the grounds with the construction of a 'Nurses Home', which is still standing, but not operating under the direct jurisdiction of the state hospital.

During the year 1901, 213 employees were listed on the books, most of whom either resided on the grounds or in the neighboring residences. Proportion of attendants to average number of patients was 1 to 9.5. The wages that were paid to attendants totaled some $59,903.00. Weekly per capita cost of operations was $3.29.

An expansion of the asylum's campus was completed between 1907 and 1909, with the construction of several new buildings funding by a state grant. This period saw the construction of: the Acute Admissions Building (Building #17), the Superintendent's House (Building #18), the Nurses' Home (Building #15), the Assembly Hall (Building #33) and the Female Convalescent Building (Building #16).

Ward for Female Untidies (Constitution House) under construction in 1937

The Commonwealth of Pennsylvania eventually responded to the pleas of overcrowding made by patients and physicians alike, and opened up Allentown State Hospital in the fall of 1910; and thus removing Lehigh and Northampton county from the jurisdiction of Norristown State. In 1937, they also purchased Byberry City Farms in Northeast Philadelphia and had it officially converted, or at least nominally converted, into Philadelphia State Hospital, which then removed Philadelphia county from Norristown's catchment area. For the most part, these changes alleviated the burden of overcrowding in state hospitals temporarily. However, within a few short decades Norristown State Hospital was again exceeding its capacity.

In 1923 the hospital's Board of Trustees voted to combine under one management with a single medical superintendent. Dr. Frederick C. Robbins was selected as the first superintendent under this combined system. For clinical psychiatry, the 1920's and 1930's saw the development of specialized departments in state hospitals, such as Social Work, Occupational Therapy, and Psychology. Additionally, Volunteer Resources, Patient Recreation, and Vocational Services were formally established as independent departments as well, with the intention of developing more specialized treatment for treating a larger diagnostic spectrum. Specialized treatment units for substance abuse, social rehabilitation, psycho-geriatrics, adolescents, and forensics, among others, were developed at Norristown during the latter 1940's and into the 1960's.

The renowned Dr. Arthur P. Noyes (1881-1963) became superintendent in 1936 and remained in that position until his retirement in 1959. Dr. Noyes started the Psychiatric Residency Program which was to be in operation for almost fifty years, operating well into the 1990's, and which gained national clinical prestige. He also opened new hospital gates (Gates #2, #3, #4 and #5) and introduced many innovations in therapeutic treatment of state hospital patients. His magnum opus, 'Modern Clinical Psychiatry', is considered a classic in the field of Psychiatry. In 1959, he was honored by being appointed as Director of Psychiatric Education for the Department of Public Welfare for the Commonwealth of Pennsylvania. A non-profit research foundation bearing his name is still active to this day. However, as the superintendent of Norristown State, Dr. Noyes oversaw one of the largest expansions of the state hospital with a large grant from the Commonwealth of Pennsylvania. Structures constructed at this time include: Female Ward for Untidy Patients (Building #8), Male Ward for Untidy Patients (Building #13), Male Disturbed Building (Building #51), Female Disturbed Building (Building #50), the Senile Building (Building #53) and the Medical Surgical Building (Building #52).

In 1949, Dr. Noyes also developed several satellite aftercare clinics in Montgomery and Bucks County for the care of state hospital patients following their treatment. This facilities eventually became independent of Norristown State Hospital, and are still in use today as community mental health clinics. All of these clinics were in association with a local general hospital, 'Central Montgomery Mental Health Clinic' was associated with Montgomery Hospital, 'Eastern Montgomery Mental Health Clinic' was associated with Abington Memorial Hospital, 'Western Montgomery Mental Health Clinic' was associated with Pottstown Memorial Hospital and 'Mental Health Guidance Clinic of Bucks County' was associated with Doylestown Hospital. All of these clinics remain active, albeit under different names, and without their former association to Norristown or their original general hospital. These became the base service units (BSU) employed by those counties for the outpatient treatment of the mentally ill. In time Bucks County's clinic split in two and became: Lenape Valley Foundation in Doylestown and Penndel Mental Health in Levittown, both of which remain active. Montgomery County's clinics became more numerous, particularly with the closure of state hospital beds. The 'Eastern' clinic was remained the Creekwood Center, which remains active, along with the 'Western' clinic, now known as Creative Health Services. Montgomery County has since contracted: Lower Merion Counseling, Penn Foundation and Northwestern Human Services to address their large mentally ill population.

Civil Public Service Unit, circa 1943

During the 1930's and 1940's electro-shock therapy (ECT), insulin coma therapy, and lobotomies became increasingly common methods of inpatient treatment. ECT was frequently employed on the grounds on Norristown until the late 1980's. Also changing the atmosphere of clinical psychiatry was the usage of psychotropic (anti-psychotic) medications beginning with the advent of Thorazine. Medications were perceived as being able to help control and lessen the severity of many of the symptoms and behaviors associated with psychotic disorders and mood lability.

During World War II staffing became a critical issue with Norristown State Hospital, as much of the nation's manpower was being diverted into the war effort. The Commonwealth of Pennsylvania deployed Civilian Public Service Unit No. 66 to the grounds to account for the absence of clinical staffing during the conflict. These mainly consisted of German Mennonites, who were conscientious objector to the war because of their faith, and were unable to participate through military service in the defeat of Germany and Japan. However, in lieu of military service, they were employed by the state on the grounds of the Norristown to work with the poor and mentally ill. They were active on the grounds from December of 1942 until October of 1946 to fill in for the shortage of available manpower that the war had created.

Two large "Consumptive Sanitoriums" were also built on the grounds at this time, Hacket Cottage (Building #40) and Johnson Cottage (Building #39), for the treatment for Pulmonary Tuberculosis. These two buildings replaced the Lower Farm House as the residence for the treatment of Tuberculosis. They were employed and active for public use until 1969, when they were closed by the state and demolished shortly thereafter. However, the circular concrete driveway for their front entrance can still be seen near Gate #4, and near Building #50.

The late 1960's and early 1970's popular psychiatry stressed an emphasis on placement of many patients into the community and county-funded outpatient clinics, known as BSU's (Base Service Unit), which remain the preferred treatment for the mentally ill. As a result, the census of Norristown State began to drop significantly, as well as at all the other state hospitals nationally. The census of the inpatient population dropped from about 3,200 in February 1968 to slightly over 1,700 in May 1973. This decline continued into the 1980's and 90's with wards being regularly shutdown by the state as a cost-cutting measure. The passing decades also brought a change in the day-to-day therapeutic process the hospital would employ. By the early 1970's, each patient had an individualized personal treatment plan and met regularly with a multidisciplinary treatment team, per the regulations implemented by the state and insurance carriers. This regulations continues to the present with each patient having a period of therapeutic treatment and psycho-educational participation each day verbalized in an individual treatment plan.

With the closure of other state psychiatric facility Norristown State appropriated a larger geographical jurisdiction. When Philadelphia State Hospital closed in 1990 a large number of their acute patients were transferred to units in Norristown for continuity of care purposes. The Commonwealth of Pennsylvania was able to allocate five million dollars in funds for this transfer. Just the same, when Haverford State Hospital was shutdown in 1998, the greater part of their inpatient population was also transferred to various buildings at Norristown. Per the work of many civil employees, Norristown also became the site of a repository of state medical records, particularly of sites that have already been shut down.

Acute Admissions Building, as of 2010

A number of the original 1880 complex have been destroyed or replaced over the years. Of the original seven building complex, only two are still standing and active. The last bit of construction to take place on the site was Building #48, which houses the Psychology Department and Building #1, 'Lenape Hall', which is an active inpatient unit for the state hospital. A number of the older residential buildings have been set to adaptive re-use, such as the original superintendent's house, which is now a Crisis Residential Program. The acute admissions building, which is damaged beyond restoration, is also used at times by local fire academies for common drills.

In more recent years, Norristown State Hospital has assimilated multiple patients and staff from the closures of other state hospitals so now it is the only remaining state hospital in Southeastern Pennsylvania. Its current catchment area is identical to the catchment area it maintainted at its opening in 1880. Many patient buildings on the grounds are no longer operational, or are uninhabitable and are awaiting demolition. Others still are leased to other mental health agencies, namely: Circle Lodge CRR, Horizon House-ACT, ShopMates, Community Homeless Outreach Center (CHOC), HopeWorx, STAR-Carelink and Montgomery County Emergency Services (MCES). The grounds are also open to the public, and frequently have pedestrians walking the grounds.

A number of the buildings on site have become considerable fire hazards because of their decay and poor condition. Collapsing roofs and small fires are not uncommon to these buildings, and the Norristown Fire Department has been called a number of times to address these re-occurring issues.

The future of Norristown State Hospital is up for some considerable debate. The site itself is overseen by two state agencies, the Department of General Services and the Department of Public Welfare, but neither has a concrete plan for its future. Total closure seems unlikely, particularly the one hundred and thirty-six patient forensic unit (Building #51) for criminally insane, which is always near its capacity. However, the infrastructure of the site is dubious at best, as the buildings range from fifty to over a hundred years old.

Since 1989, the Commonwealth of Pennsylvania has Closed approximately 1300 state hospital beds, as part of their 'Community Hospital Integration Project Plans' (CHIPPs). The intention has long been the total closure of the state hospital system, which had been moving forward with haste in the past twenty years. Locally, Philadelphia State Hospital was closed in 1989 after several lawsuits. Haverford State Hospital was closed in 1998 under similar terms. The commonwealth also closed the doors on Allentown State Hospital in 2010 and Harrisburg State Hospital in 2006, leaving a remaining handful of sites active. The civilian population at Norristown has been on a strategic decline; 410 beds in 2001, 366 beds in 2002, 306 beds in 2003, 304 beds in 2004, 304 in 2005, 304 in 2006, 294 in 2007, 264 beds in 2008, 234 beds in 2009 and 204 beds in 2010. There have been serious talks about a closure of the civilian division of the state hospital, with the intent to divert their acute population into local long-term structured residences (LTSR), but that has yet to materialize.

In 1880, Dr. (Mary) Alice Bennett, was appointed superintendent of the Women’s Department at Norristown State Asylum, the first woman in the nation to direct a female division in a psychiatric institution. She graduated with an MD from the Women’s Medical College of Pennsylvania (Now part of Drexel University School of Medicine) in 1876 and a PhD from the University of Pennsylvania in 1880, where she was also a graduate lecturer. She was aided in this appointment by fellow classmate, Dr. Anna Kugler, who acted as her assistant physician. During her tenure, Dr. Bennett profited from the Victorian notion that as a woman physician, she could best treat patients of her own sex and in turn, introduced her own ideas of patient management. The asylum superintendents had a variety of opinions regarding the subjects of a female physician. Dr. Gray out of of Utica, NY, Dr. Kirkbride in Philadelphia, PA and Dr. Chapin of Willard, NY all wrote letters to their governors opposing the employment of these women-physicians. However, they largely fell on deaf ears.

Dr. Bennett abolished the practice of straitjackets and chains on patients at Norristown during her tenure, which previously had been commonplace through many western asylums. Instead, she contended that such restraints were ineffective and would only result in a patient's anger and a growing resentment towards their caregiver. She therefore theorized that checking the patients' energy into a single direction by physically constraining them would sublimate that energy to another potential outlet. She believed that restraints contradicted the ethical treatment of patients, as proposed by Quaker York retreat decades earlier, one based on mutual respect between patient and caregiver. Dr. Bennett also introduced occupational therapy to Norristown, such as music, painting, and handicrafts. Other asylums for the mentally ill adopted this practice and her policy of non-restraint, winning her widespread professional recognition in the young field of clinical psychiatry.

In 1890, the Montgomery County Medical Society in Pennsylvania elected her to be their first woman president. She was also a member of the American Medical Association, the Philadelphia Neurological Society, and the Philadelphia Medical Jurisprudence Society, and was one of the original incorporators of the Spring Garden Unitarian Church of Philadelphia. Dr. Bennett also was on the board of trustees, as the commissioner, and assisted in the design of Wernersville State Hospital in 1892. After sixteen years as superintendent at Norristown, Bennett returned to private practice in her hometown of Wrentham, NY in 1896.

In 1892, the Board of Public Charities accused the medical staff of Norristown State Hospital, under the orders of Dr. Alice Bennett of surgical experimentation on human subjects, after the removal of the ovaries of six women were reported as a cure for Insanity. Under the alluring title, "An Experimentation in Castration" the New York Medical Record editorially gives the following unique item of news:

"An interesting experiment has suddenly come to grief at the Norristown Insane Asylum, Pa. Some of the medical staff became much impressed with the value of castrating women as a therapeutic measure in insanity."

This was initially met with some approval from the scientific community, and was also seen with great interest by Dr. Thomas Morton, then head of the male department in Norristown. Each subjects was specified in anonymity, with full results published by the medical staff. In Dr. Bennett's own words, "to summarize: of the six cases operates upon, three, or half the number, have perfectly recovered in body and mind. One is much improved. One is improved in some respect and not others. One died. It is of interest to note that five of the six, were of puerperal origin." Two of the six result records are as follows:

Case 1- Age, 49 years; American; married; mother of four children, of which the youngest is eighteen years old. The first attack of mania followed the birth of her first child, 29 years ago. The present attack is the fifth and came about two months before her admission to the hospital, May 24th 1892. Mental Condition- mania of a mild type with delusions. Physical Condition- General debility with anemia, small amount of albumen and mucous casts in the urine. Internal Examination showed uterus retroflexed and drawn to the left side. The attacks of insanity had always been by periods of severe pain in the region of the left ovary. Operation done July 3, 1893, by Dr. Marie Werner, assisted by Dr. Joseph Prion; there were present Dr. L. McMurty, of Louisville, KY, Drs. Kollock and McAllister, of Philadelphia; Drs. Bennett, Taher, Willits and Lothrop of the hospital staff. Both the ovaries and tubes were removed by the abdominal section. Condition of the Organs Removed- left ovary contained many cyatic tumors. Right ovary with calcareous deposits; tuberculosis degeneration in left tube. Result- Patient recover rapidly from the operation, and she went home completely restored in body and mind on the 6th of August [1892], a little more than four weeks after the operation.

Case 2- Age, 28 years; American; white; single; apparent family predisposition to insanity. Patient had lives and irregular life, and is said to have suffered from internal trouble, dating from an abortion produce five years before. Admitted to hospital, August 24th 1888. Mental Condition- Melancholia, with stupor for the first year; for the following three years, lucid intervals, alternating with periods of violent maniacal excitement, during which she becomes profane, obscene, destructive and suicidal. Physical Condition- General condition poor upon admission; urine contained albumen and hyaline casts. Internal Examination- showed uterus prolapsed, enlarged and fixed; profuse secretion; masses felt in regions of both ovaries; sensitive to pressure. Much localized pain suffered at times. No permanent improvement followed local treatment. Operation done on time with Case 1. Ovaries and tubes removed on both sides by abdominal section. Condition of organs removed- Hydrosalphix of both sides. Adhesions of extraordinary firmness, roofing in the pelvis and binding tubes and ovaries and adjacent tissues in one mass, of which the parts were almost indistinguishable. Result- Recovered rapidly and went home well physically and mentally, on the 17th of September 1892. Note- the patient was subsequently examined by Dr. Morton, who wrote to congratulate me upon the result.

Late backlash would shed these experiments in a different light. James J. Levick stated, “Insanity is a disease of the brain, not of some organ remote from it; and when manifestation of insanity seem to be especially associated with functional disturbances of some one organ, this disturbance is secondary to the brain disorder, not the cause of it.” Those who opposed this procedure greatly rejoiced that, “the hospitals and the profession are saved from a scandalous proceeding.” However, practices such as these were also common place in neighboring Trenton State Hospital under the infamous Dr. Cotton, where teeth were removed to cure the psychotic features of a patient. It was further questioned whether Gynecology should be practiced in Asylums at all, and if an insane person should be treated gynecologically just as any other person would be treated, and that an examination, diagnosis and treatment ought to be instituted independent of her mental condition.

There is no note what followed these experiments in any journal, as they are only practiced for a few months in 1892. There appears to be no documentation of any backlash directed towards Dr. Bennett, or her staff physicians, for the unethical nature of these experiments; or for that matter, the resulting death that took place because of her work.

Like many state hospitals, Norristown has had alleged cases of patient abuse since it's opening. IN 1882, Mary Ritchie, an eighty years old resident of the hospital, had her arm fractured because she refused to take a bath. She was seized by two of the attendants, and in the struggle her arm was broken. Mary Green, one of the attendants, was then discharged by the asylum committee. Just the same, another patient, Jacob Miller, also had an arm broken by the attendants, and three of the men employed in the male department were discharged. These unfortunates had suffered most at the hands of the attendants.[1]

On August 4, 1883, William A. J. Fiss died in the hands of James Gaffey, an asylum attendant, after he struck Fiss in the head. Fiss became incoherent and died from blood poisoning at 12:45 am. that morning. [2]

With the introduction of Electroshock therapy (ECT) in the 1940's there was significant talk of its clinical overuse. The superintendent of the time, Dr. Nolan D. Lewis, discounted these criticisms and maintained that ECT was being employed regularly, but with 'Conservative discretion'. He made the argument that its use was limited to patients who were unresponsive to continuous baths, and that other methods of sedation were preferable, and employed before ECT could be suggested.

Hospital staff were themselves not safe from abuse at the hands of hospital administrators of the mid-20th century. It is noted that during the 1948 fiscal year, six hundred staff members were hired for direct care of patients on various units. However, within the year three hundred and fifty resigned their posts, and nearly two hundred were fired. By many superintendent's admission, the task of working with the mentally ill was taxing, and presented: low pay, extended hours of the work week, little recreation and substandard housing for employees. However, often times the welfare of the attendants was also dubious, as the commonwealth placed a number of their employees in hazardous situations due to financial constraints.[3][4][5]

Norristown State Hospital was built in three separate stages, all of which represent different stylistic approaches to architecture and psychiatric therapies. The first phase of construction lasted from: 1878 until 1910, which encompassed most of the Transitional-Kirkbride complex, and is in the Victorian High Gothic Style, or the slightly toned-down Edwardian. The next phase, which was the largest of the campus, came between 1937 and 1940, and was noted for its larger and more utilitarian buildings. This period of state hospital construction was particularly noted for its banality, and has been criticized as "warehousing" patients. The final stage of growth was in the mid-1960's, which saw the demolition of a number of older structures, and their replacement with their sterile 'art deco' equivalents. The names of buildings that follow are how they would be known, circa 1940:

Ward Five, 1880

Building #1 Female Acute Ward Building- Active; the original was demolished in the 1960's and rebuilt across the street as an active inpatient unit for the state hospital. The original building #1 was a red brick structure with an interior courtyard built in 1883. It was the only building from the original complex not to be finished on schedule because of a lack of funds. The current structure of Building #1 is made from white bricks and a limestone facade, with a more contemporary design. It is sometimes referred to as 'Lenape Hall'. The Toggery shop is still active and open to the public. This building houses a theater and an indoor pool.

Building #2 Female Ward Building- Abandoned; was used to house the Regional Mental Health Resource Coordination Office of Southeast Pennsylvania. It was built in 1880 and was originally designed to accommodate mid-acuity patients for the Female Department.

Building #3 Female Ward Building- Demolished; It was built in 1880 and was originally used for mid-acuity patients for the Female Department.

Building #4 Female Ward Building- Demolished; It was built in 1880 and was originally used for low-acuity patients for the Female Department.

Building #5 Male Ward Building- Abandoned; It was built in 1880 and was originally used for low-acuity patients for the Male Department. In more recent years it was leased for offices by the Philadelphia Mental Health Care Corporation (PHMCC).

Building #6 Male Ward Building- Partially Abandoned; It was built in 1880 and was originally used for mid-acuity patients for the Male Department. The back of the building is still active and is leased by HopeWorx for the Consumer Satisfaction Team.

Building #7 Male Ward Building- Demolished; It was built in 1880 and was originally used for mid-acuity patients for the Male Department. It is now a community garden.

Building #8 Male Acute Ward Building- Abandoned; It was built in 1880 and demolished in 1937, rebuilt that same year as a new ward for high acuity patients.

Female Infirmary, 1893

Building #9 Male Hydro-therapy Building- Active; The original was built in 1887 and originally it was designated as the male infirmary ward until 1937 when medical procedures were conducted in the medical-surgical building. It replaced the prior one story co-ed infirmary on the grounds. The original was demolished and replaced with the new Building #9, also known as 'Harriet Tubman House', which held the hospital's neurology ward and long-term care ward well into the 1990's. It currently houses the hospital's geropsychiatric population.

Building #10 Female Hydro-therapy Building- Active; The original was built in 1887 and originally it was designated as the male infirmary ward until 1937 when medical procedures were conducted in the medical-surgical building. It replaced the prior one story co-ed infirmary on the grounds. It was demolished in the late 1950's and replaced with the new Building #10, also known as Pennsylvania House', and acts as an inpatient unit for the current state hospital.

Building #11 Unknown- A brief report from 1907 stated that Ward #11 had "a destructive fire [that] almost destroyed ward building No. 11. Fortunately, the fire occurred early in the evening and by prompt action all the inmates were saved and no one was injured." However, its fate was never specified. There is a current Building #11, known as 'York House'; however, it too appears to be abandoned.

Building #12 Female Acute Ward- currently houses nursing administration and the psychology department; Also known as 'Benjamin Rush'. It was active until fairly recently as an inpatient unit for the state hospital.

Building #13 Male Ward for Untidy Patients- Active; Also known as 'Heritage House'. Built in 1937 for the care of the "untidy", it is currently leased to the STAR Program. "Untidy" is the archaic distinction used for patients who are not capable of bathing themselves.

Building #14 Female Ward for Untidy Patients- Abandoned; Built in 1937 for the care of the "untidy",which is the archaic distinction used for patients who are not capable of bathing themselves. Also known in its later life as Constitution House; it was in use into the 1990's as a Gero-Psychiatric unit and as a records repository.

Central Kitchen, 1893

Building #15 Female Nurses Home- Active; It was built in 1897 and was used as staff housing for female nurses and students and the hospital's nursing school. Its original capacity was 105-beds. However, at some point it had a destructive fire which damaged much of the original building. It is now being leased to Circle Lodge as a community residence for mental health consumers.

Building #16 Female Convalescent Building- Demolished; It was built in 1907 for $50,000, and boasted that it had enough beds for seventy female patients. The term 'Convalescent' was used in the period for what was then known as "shell-shock" or "Railroad Spine", subdivisions of Neurosis. Re-purposed in the early 1970's as a private psychiatric respite program. It was abandoned in 1988, and demolished in 2009.

Building #17 Acute Admission Building- Abandoned; when it was active it was used to filter some of the more acute patients coming onto the grounds. However, it has not seen active use since the early 1970's.

Building #18 Superintendent's House-Demolished; used to accommodate the lodgings of the superintendent, and thus never keeping him far from his work. It was at a later time used as a doctor's lounge by hospital staff and was active well into the 1990's. Demolished in 2017

Building #19 Administration Building- Active; Built in 1878 and is still used as the primary office for the state hospital's administration since 1880. Their entrance way is decorated with old photos and portraits of superintendents. The famous cupola was removed as a cost-cutting measure sometime in the familiar past, but no date has been specified.

Building #20 Chapel- Demolished; only the basement survives as an underground tunnel.

Building #21 Kitchen- Active; used to provide food for both male and female refactories. Now used for storage and assorted things. It is current being leased by Shopmates.

Male Refactory, 1893

Building #22 Male Refactory- Active; It was built in 1887 and was originally a cafeteria for male patients. Now used for state hospital security.

Building #23 Female Refactory- Active; It was built in 1887 and was originally a cafeteria for female patients. Now used for storage by the state hospital.

Building #24 Surgical Building- Demolished; Built in 1908, it was intended to serve as a center for more complicated surgeries. It was reappropriated in 1937 to serve a strictly gynecological function.

Building #27 Coal Shack- Unknown; This large structure was the original source of power for the hospital when it opened its doors in the 19th century.

Building #29 Carpentry Shop- Active; current purpose unknown.

Building #31 Storage Building- Demolished.

Building #32 Employees Building- Abandoned; Staff housing and lounge built in the late 1930's for individuals who lived on campus.

Building #33 Assembly Hall- The original 1909 building was demolished in the mid-1960's. The lower floor of the 1909 held an ornate dance hall, while the upper floor contained an auditorium for religious and assembly purposes, with gradual sloping floor, large stage and fixed theater seats for one thousand two hundred patients. A pipe organ was also installed through the generosity of the Commonwealth's Legislature. The current Building #33 is from the late 1960's, and was intended to replace that structure, which was believed to be in disrepair. It is sometimes used for arts festivals; however, that is rare anymore. There is still a chapel in it's basement with a chaplain present at times in the early morning.

Building #34 Pathological Lab and Morgue- Demolished; The original structure was built in 1906, but was demolished and rebuilt as Building #54.

Conservatory, 1893

Building #35 Hartranft Cottage- Demolished/Active; formally a staff dormitory, similar to Building #32. Now it is the site of a police barracks. Presumably it is named after the governor who founded Norristown State Hospital. The number was reassigned in the 1960's to a new maintenance building, which is still active.

Building #36 Males Nurses Home- Demolished; Built in 1895 it was used as staff housing for male nurses and students of the nursing school on the grounds of the hospital. It was intended to be the male equivalent of Building #15

Building #37 Male Convalescent Building- Demolished; used for what was then known as "shell-shock" and "railroad spine", subdivisions of Neurosis.

Building #38 Laundry Building- Partially Demolished, Built in 1938, part of it stands as part of the above ground hospital tunnels.

Building #39 Charles Johnson Cottage for Consumptive Males- Demolished; Built in 1937 and served as a TB Hospital for men, in use until 1969, demolished thereafter.

Building #40 Hackett Cottage for Consumptive Females- Demolished; It was built in 1937 and served as a TB Hospital for women. It was still in working order and in use until 1969, demolished thereafter. A cottage built in 1899 preceded it on the site, but was also demolished as it could only hold twenty women.

Building #41 Supply Storage Building- Active; Built in 1937 and still in use for the same purpose it was designed.

Building #43 Greenhouse- Active; Built in 1887, but replaced several times. It is still used by the state hospital for the sale of produce on Wednesdays and Thursdays.

Building #45 Old Superintendent's House- Active; Possibly the oldest building on the campus, with no specified date of construction. It served as the home of the superintendent until 1908. It was re-appropriated as a residence for doctors thereafter, particularly residents. It is currently being leased to a Crisis Residential Program.

Building #46 Gate House- Demolished; used to monitor visitors to the grounds until other gates were opened in 1936. It stood as the original location of state hospital security.

Building #47 Staff Garage- Abandoned.

Building #48 Psychology Department- Active; Built in the mid-1960's and used for community lectures and public events.

Building #49 Boiler House- Active.

Building #50 Female Disturbed Building- Active; It was built in 1938 as a pairing to Building #51, with similar floor plans, to house the criminally insane. It is currently being leased to Montgomery County Emergency Service (MCES), but it was in use as the state hospital's forensic unit until 1988.

Building #51 Male Disturbed Building- Active; Also known as 'Brandywine House'. It was built in 1937 as a pairing to Building #50, with similar floor plans, to house the criminally insane. The back of the structure was formally the gym for the state hospital, but it has since been restricted with the construction of an imposing fence. It is the current state hospital forensic center for both men and women.

Building #52 Medical Surgical Building- Abandoned; Also known as 'Franklin Hall'. Built in 1937 to relieve the prior hospital infirmaries, and replace them with modern medical practices. It was converted and used as Norristown State Hospital Admission Building, following the closure of Building #17, from the 1970's until 2005. It held a number of other functions when operational. The hospital used it for outpatient clinics, community liaisons and for pre-admission screenings.

Building #53 Senile Building- Active; Also known as 'Republic House'. Build in 1939 and previously used to treat patients with various degrees of Dementia. It held the hospital's long-term care ward well into the 1990's. Currently, it is being leased to RHD-CHOC as a community homeless shelter.

Building #54 The HUB- Hospital cafeteria, operated by patients. Formally it held a patient general store and library, the remains of which can be seen but are not operational.

Building #56 Lower Farm House- This was the original 19th century house for female TB patients, before the larger wards were completed. It is currently being used by Horizon House Services. When it was built is unclear.

Building #57 Guardian Office- Active; This structure was built in the mid-1960's and holds a number of administrative office for the current state hospital, such as: the office of revenue and program review.

Building #61 Power Station- Active; This is fairly modern and is a power station for the remaining active buildings.

In January of 2018, following the announcement of the closure of the civil section of Norristown State Hospital, a collection of locals have attempted to compile a folk history of the hospital and its legacy. They are currently collecting photos, documents, memoirs, and other assorted artifacts regarding the impact of the hospital on the region.